Background: We retrospectively analyzed the 5-year biochemical disease-free survival (bDFS) and occurrence of late toxicity in prostate cancer patients treated with pencil beam scanning (PBS) proton radiotherapy. Methodology: In the period from January 2013 to June 2018, 853 patients with prostate cancer were treated with an ultra-hypofractionated schedule (36.25 GyE/five fractions). The mean PSA value was 6.7 (0.7–19.7) µg/L. There were 318 (37.3%), 314 (36.8%), and 221 (25.9%) patients at low (LR), favorable intermediate (F-IR), and unfavorable intermediate risk (U-IR), respectively. Neoadjuvant hormonal therapy was administered to 197 (23.1%) patients, and 7 (0.8%) patients had adjuvant hormonal therapy. The whole group of patients reached median follow-up time at 62.7 months, and their mean age was 64.8 (40.0–85.7) years. The bDFS rates and late toxicity profile were evaluated. Results: Median treatment time was 10 (7–38) days. Estimated 5-year bDFS rates were 96.5%, 93.7%, and 91.2% for low-, favorable intermediate-, and unfavorable intermediate-risk groups, respectively. Cumulative late toxicity (CTCAE v4.0) of G2+ was as follows: gastrointestinal (GI)—G2: 9.1%; G3: 0.5%; genitourinary (GU)—G2: 4.3%, and no G3 toxicity was observed. PSA relapse was observed in 58 (6.8%) patients: 16 local, 22 lymph node, 4 bone recurrences, and 10 combined sites of relapse were detected. Throughout the follow-up period, 40 patients (4.7%) died, though none due to prostate cancer. Conclusion: Ultra-hypofractionated proton beam radiotherapy is an effective treatment for low- and favorable intermediate-risk prostate cancer, with long-term bDFS rates comparable to other techniques. It is promising for unfavorable intermediate-risk prostate cancer and has acceptable long-term GI and favorable GU toxicity.
背景：本研究回顾性分析了接受笔形束扫描质子放疗的前列腺癌患者的5年生化无病生存率及晚期毒性反应发生情况。方法：2013年1月至2018年6月期间，853例前列腺癌患者接受了超分割放疗方案治疗（36.25 GyE/五次分割）。患者平均PSA值为6.7（范围0.7-19.7）µg/L。其中低危组、有利中危组和不利中危组患者分别为318例（37.3%）、314例（36.8%）和221例（25.9%）。197例（23.1%）患者接受了新辅助激素治疗，7例（0.8%）患者接受了辅助激素治疗。全组患者中位随访时间达62.7个月，平均年龄64.8（范围40.0-85.7）岁。研究评估了生化无病生存率及晚期毒性特征。结果：中位治疗时间为10（范围7-38）天。低危组、有利中危组和不利中危组的5年生化无病生存率估计值分别为96.5%、93.7%和91.2%。G2+级累积晚期毒性（CTCAE v4.0标准）表现为：胃肠道毒性——G2级9.1%，G3级0.5%；泌尿生殖系统毒性——G2级4.3%，未观察到G3级毒性。58例（6.8%）患者出现PSA复发，其中局部复发16例，淋巴结复发22例，骨转移4例，多部位复合复发10例。随访期间共有40例（4.7%）患者死亡，但无前列腺癌相关死亡病例。结论：超分割质子束放疗是治疗低危和有利中危前列腺癌的有效方法，其长期生化无病生存率与其他技术相当。该疗法对不利中危前列腺癌具有良好前景，且长期胃肠道毒性可接受，泌尿生殖系统毒性控制良好。
肿瘤(癌症)患者之家